=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922204536
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID CHRISTOPHER JENNINGS DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2007
-----------------------------------------------------
Last Update Date | 09/23/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6161 S YALE AVE 4TH FLOOR REHABILITATION UNIT
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74136-1902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-494-4250
-----------------------------------------------------
Fax | 918-494-4299
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6600 S YALE AVE STE 1400
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74136-3331
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-499-4855
-----------------------------------------------------
Fax | 918-488-6098
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number | 4593
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 4593
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------